Clark, Susan Marie

Clark, Susan Marie is an sole proprietor health care provider with primary practice located at 10 Wilson Rd , Stockbridge GA 30281-4468. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Pastoral. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Clark, Susan Marie can be contacted via phone (678) 438-4225.

Contact Information

Primary practice address
10 Wilson Rd Stockbridge GA 30281-4468
Phone: (678) 438-4225
Fax: (770) 506-8663
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X LPC005485 Georgia
Behavioral Health & Social Service Providers / Mental Health 101YM0800X LPC005485 Georgia
Behavioral Health & Social Service Providers / Pastoral 101YP1600X LPC005485 Georgia

Profile Details

NPI number 1154590073
LBN Legal business name Clark, Susan Marie
Credentials PH.D
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 25th, 2008
Last updated Jan 5th, 2009 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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